Pertussis Symptoms and Diagnosis

What Are the Symptoms of Pertussis?

Symptoms of pertussis start 7 to 10 days after being exposed and vary by age. They usually begin as cold-like symptoms including a runny nose, tearing eyes, fatigue and fever. It is not until the disease progresses that it can differentiate itself from other respiratory illnesses.

Many babies with pertussis may not cough at all. They often instead stop breathing and turn blue, requiring emergency medical attention.

After a week or two, children, teens and adults with pertussis may develop a harsh repetitive cough, sometimes accompanied by a “whooping” sound. This sound happens when all the air is gone from your lungs, and so you inhale as you cough, creating a “whoop.” Individuals experiencing milder disease, such as those who have been vaccinated against pertussis, tend not to experience the ‘whooping’ cough.

These intense coughing spells will often result in loss of bladder control, vomiting and cause exhaustion, light-headedness and headaches. The lips and areas around the lips may even turn blue immediately after a coughing spell. The cough may be brought on by yawning, stretching, laughing, yelling or exercise. It may start by being more frequent at night, but the longer pertussis goes without treatment, the more common the fits will become until the disease runs its course, which can be several months.

Symptoms of pertussis in adolescents and adults are often less severe than in infants and children, particularly if they were vaccinated as children. However, high risk individuals, including adults with asthma, may be at greater risk for complications.

How Is Pertussis Diagnosed?

Because the symptoms are similar to those of other respiratory illnesses, it is rare for a diagnosis to be made in the early stages. However, once the illness has progressed, your doctor may be able to make a diagnosis by simply taking a medical history, doing a physical exam and listening to your cough.

To confirm a diagnosis, your doctor may want to run some tests. By taking a nose and throat swab, they can test for the Bordetella pertussis bacteria in culture or a more rapid polymerase chain reaction testYour doctor may suggest a blood test to check your white blood cell count, which, if low, signals the presence of an infection. This test will normally be done in conjunction with others, though, because the results can’t be linked decisively to pertussis. If your doctor is concerned about complications, like pneumonia, they may suggest an imaging test, such as a chest X-ray.

When to See Your Doctor

If you have been exposed to someone in your household infected with pertussis, talk to your doctor about preventative antibiotic therapy. Anyone with a prolonged, persistent debilitating cough should see a physician immediately. After diagnosis, report any signs of dehydration to your doctor immediately. These include dry, sticky mouth, sleepiness or tiredness, thirst, decreased urination or fewer wet diapers, few or no tears when crying, muscle weakness, headache, dizziness or lightheadedness.

Reviewed and approved by the American Lung Association Scientific and Medical Editorial Review Panel.

Page last updated: November 17, 2022

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